Q: What is your current position?
I'm actually a nurse midwife. I do comprehensive gynecology, and I also do antepartum care. I don't do births at the hospital, but I do postpartum care and lactation support. I have additional training for colposcopy, which is evaluation of women that have abnormal Pap smears. I actually also work as a part-time consultant for Planned Parenthood. I do all their colposcopies. I do a lot of IUD insertions and Implanon insertions.
Q: What is women's health nursing?
It's the care of women over their lifespan in any specialty, really. Obviously, there's the women's health nurse, the educator and the specialties that focus on childbearing. There are other specialties that focus on adolescence, menopause or geriatric care. A lot of the time, women have very specific risk factors in each stage of their life.
Q: How did you get started in this field, and what kind of preparation does someone pursuing this career need?
When I went into nursing many years ago, I thought I wanted to work in the emergency room, and I never have. I've worked in pediatrics, neurosurgery, outpatient surgery, ICU, and CCU. And then, by chance, when I was in Sumter, South Carolina, the only job opening they had was for a labor delivery nurse.
At that time, I only had a year of nursing experience, and I was put into the night shift position in a community hospital that was very busy to be the charge nurse. The only way I survived was that they had two nursing aides who knew a whole lot more about childbirth than I did. And, they kept me out of trouble, thank goodness. At night when the unit was slow, I stayed awake by reading Williams Obstetrics, and I basically learned OB by default. But, I think because of the tutelage I had, and the mentoring I had, I became very good at it. And so it became my career path.
Q: What career options are available in women's health?
Quite honestly, when I started out, before I decided to go to nursing school, I thought I wanted to be a physical therapist. I guess the biggest message is, when you decide to go into a four-year program, keep your options open. Even though you may be interested in women's health care - or you may want to do exercise physiology, nutrition, or something else - keep your options open because when you go to school, you're going to be introduced to so many opportunities that you may not have been aware of. You can focus your career path or change your career path basically anytime.
Q: What is an average day like for a women's health nurse?
Basically, the day starts out with a report. It's a way to figure out who's in labor, who's not, who's coming in, and what you're expecting for the day. You can have women who are coming in to be induced or have scheduled C-sections. And then you have the unknown, those who are going to show up in labor. You can have women who are term, who you're trying to encourage to go into labor; you can have women who are preterm who you're trying to stop from going into labor. You can have women in labor and delivery who have delivered but are so medically unstable that you have to keep them in the unit so that they can have the nursing one-on-one care.
As an individual nurse, you can expect to take care of anywhere from one to several laboring patients. The rewards are immense. Even if the pregnancy outcome is not what was hoped for, the feeling of having successfully brought another human being into the world never loses its appeal. It's always fun. It's always rewarding, even on the worst day.
Q: In general, are there any specific traits that work well in this career?
That's what keeps it very exciting. You're always learning, always changing. That's true in any health care field. When I finished nursing school back in 1981 with my baccalaureate, I swore that I would never go back to school. I'd had it. And, I've been back to school three times. It's because the more you know, the more you want to know. I'm never bored. Every day I get to see 20 women who I consider my friends, and it's a privilege. I get to visit with them and get a peek into their lives and hopefully have a positive impact for them. And it's something you just don't grow tired of, if you like it.
Q: What are some of the challenges in the field?
It's very frustrating, as a provider, to try to help patients figure out what their coverage is, and what it is not. I teach a lot of young women, just because I see them for contraceptive needs or pregnancy, to try to negotiate the health care maze. Your particular policy can almost vary night and day. It can vary year to year. It can vary or change every time you change your job. People don't know their insurance benefits, and it makes it very tricky for me, as a provider and a consumer, to figure out how to manage costs.
Q: What kind of changes have there been in women's health in the last few years?
I've been in nursing almost 35 years, and that predates the discovery of HIV. That was probably the biggest change in health care during my career. But the second biggest one, I'd say, is going to be HPV. I remember learning about the role that HPV plays in cervical cancer, and I was dumbfounded that a virus could cause a cancer. And now we take that knowledge for granted, and we have the opportunities to vaccinate, and help protect future generations. Now, I don't have patients coming in every three to six months for repeat Pap smears because we can test for the HPV and target their care more specifically and more cost-effectively. There are also the changes in contraceptives that have become available, Plan B, for example. To have a contraceptive option after the fact was unheard of 30 years ago.
Q: What do you see for the future of women's health?
Surveillance for breast health, for example. Now digital mammography is the standard of care. In the past, when it was first introduced, you had to specifically say, "digital mammography." It gives the opportunity for the films to be stored on computers, and the images can be lightened or darkened or rotated, decreasing multiple mammogram exposures on many occasions. Now we're also able to target recommendations that even include MRI in screening of high-risk populations. With genetic testing, there's lots of focus now on prevention and screening. If a family member is diagnosed with, for example, breast, colon or ovarian cancer, we can start to do more genetic testing, and get a better handle on risk for other family members.
Q: Any other recommendations for aspiring women's health professionals?
I think the challenge that I heard from many of the high school students who I taught was that they were intimidated by the cost of education. If cost is a factor for you, start out small. For example, start out at a community college, decide if that's the career path you want to take, and then you can go to a four-year college by transferring. Or if college is out of the picture for you, try to become a CNA. Then once you get a job, many employers will pay for you to finish school, or go to school. Don't be intimidated by the cost.
Jennifer L.W. Fink, RN, BSN is a professional freelance writer with almost a decade of experience as a Registered Nurse. She's worked in both hospitals and nursing homes as a med-surg, geriatric and transplant nurse. Her national publication credits include Parents, RN, Ladies' Home Journal, Nursing Spectrum, Pregnancy and Journal of Christian Nursing.
Women's health nursing revolves around the reproductive and gynecologic health needs of women. Even so, most women's health nurses take a much broader view, recognizing the fact that health cannot be distilled down to a single body system. Women's health nurses consider their patients in context and examine their patient's physical, emotional, and spiritual health as well as their living arrangements.
Women's health nurses are found throughout the healthcare system. Some practice in the offices of OB/GYNs. Others work at community health clinics or for home care agencies. Some women's health nurses specialize in the care of pregnant women, while others focus on labor, delivery and post-partum care. Some pursue certification as lactation consultants, while others return to school to become nurse practitioners (NPs) in women&rsquos health or certified nurse midwives (CNMs).
Nurses who work primarily with pregnant women in physicians' offices assess patients' vital signs, monitor patient weights and perform routine urine tests. They also discuss patient concerns and may provide anticipatory guidance and emotional support. Other women's health nurses, particularly those in the community, may be actively engaged in education and advocacy. Some nurses work within the community to decrease teen pregnancy rates or to encourage healthy behavior during pregnancy. Others run sex education classes that teach safe sex and STD prevention, encouraging and empowering women to take charge of their own sexual health.
Labor and delivery nurses care for women during childbirth. They monitor the vital signs of mother and baby, to ensure the safety of both. They also monitor the strength and frequency of contractions and vaginal dilation and report their finding to the physician. Most importantly, they provide comfort to the laboring mom, often suggesting alternative positions and non-pharmacological methods of pain control. Labor and delivery nurses also administer pain medications as ordered.
After birth, women's health nurses monitor mothers for possible infection or hemorrhage. They teach self-care to the moms, and the basics of baby care to the parents. They also help new moms learn to breastfeed. Some women's health nurses provide baby care as well.
Women's health nurses are extremely attuned to the unique health concerns of women. They understand the intersection between a woman's health and her ability to fulfill her roles as a daughter, wife, mother, employee and friend. They watch for signs of possible family violence as well; women are far more likely to be emotionally and physically abused than men. If a women's health nurse suspects any kind of abuse, she reports it to the local authorities and gives the woman information about how to remain safe.
Because women set the tone for family health, women's health nurses strive to establish good working relationships with their patients. They know that women who are pleased with their healthcare are women who bring their families in for checkups.